Psychotropic Medication Utilization at a Group-Home Residential Facility for Children and Adolescents

Handwerk, Michael L.; Smith, Gail L.; Thompson, Ronald W.; Spellman, Douglas F.; Daly, Daniel L.

doi:10.1089/cap.2008.012

Cited by 22 publications

(11 citation statements)

References 24 publications

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“…TFM homes implement a well-specified model that utilizes proactive behavior approaches focused on promoting youth strengths, highly trained and supervised staff, ongoing professional consultation, and a focus on family-style living (U.S. Department of Health and Human Services, 1999;Wolf et al, 1995;Wolf et al, 1976). Many of the core TFM elements have been linked to positive youth outcomes (e.g., Friman et al, 1996;Gilman & Handwerk, 2001;Handwerk, Smith, Thompson, Spellman, & Daly, 2008;Handwerk, Turk, Hoff, Lucas, & Friman, 2006;Jones & Timbers, 2003;Larzelere, Daly, Davis, Chmelka, & Handwerk, 2004;Lee, Chmelka, & Thompson, 2010;Lee & Thompson, 2009;McNeal, Field, Handwerk, Roberts, & Friman, 2006). Much of this evidence, however, is either very dated or based on selected settings (Fixsen & Blasé, 2002;Kirigin, Braukmann, Atwater, & Wolf, 1982;Lazelere, Smith, & Daly, 1997;Thompson et al, 1996).…”

Section: Journal Ofmentioning

confidence: 99%

“…Pre-post findings about change across time while youth reside in TFM homes have been mostly positive (Gilman & Handwerk, 2001; Handwerk et al, 2008; Handwerk et al, 2006; Larzelere et al, 2004; Lee et al, 2010; Lee & Thompson, 2009; McNeal et al, 2006). Outcomes include higher youth-reported hope for the future (McNeal et al, 2006); increased self-reported life satisfaction related to view of self, school, and friends (Gilman & Handwerk, 2001); and significantly fewer youth meeting criteria for psychiatric disorders (Handwerk et al, 2006).…”

mentioning

confidence: 99%

“…Outcomes include higher youth-reported hope for the future (McNeal et al, 2006); increased self-reported life satisfaction related to view of self, school, and friends (Gilman & Handwerk, 2001); and significantly fewer youth meeting criteria for psychiatric disorders (Handwerk et al, 2006). By discharge, youth are reported to have decreased medication rates (Handwerk et al, 2008), fewer externalizing and internalizing behaviors and psychiatric symptoms, and discharge to less restrictive settings (Larzelere et al, 2004). …”

mentioning

confidence: 99%

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Does Model Matter? Examining Change Across Time for Youth in Group Homes

Farmer

Seifert

Wagner

et al. 2016

Journal of Emotional and Behavioral Disorders

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Group homes are a frequently used but controversial treatment setting for youth with mental health problems. Within the relatively sparse literature on group homes, there is some evidence that some models of treatment may be associated with more positive outcomes for youth. This article explores this possibility by examining differences across time for youth served in group homes utilizing the Teaching Family Model (TFM) and geographically proximate homes using more eclectic approaches. Data come from a longitudinal quasi-experimental study that included 554 youth. Results suggest that youth showed, on average, significant and rapid improvement during initial months in a group home. Improvement did not differ for TFM and non-TFM homes during this initial period. Post-discharge results, though, show that TFM was associated with continued improvement after discharge and significantly better outcomes by 8 months post-discharge. Results also discuss youth-level factors that may influence outcomes as well as need for additional work to more fully understand processes and practices that are key for maximizing and maintaining youths’ positive outcomes during and after group home placements.

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Section: Journal Ofmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Does Model Matter? Examining Change Across Time for Youth in Group Homes

Farmer

Seifert

Wagner

et al. 2016

Journal of Emotional and Behavioral Disorders

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“…Therefore, we conducted our first study related to this issue using archival data to track medication use at admission to the Family Home Program, during care, and at discharge. We found that 40% of youth were admitted on psychotropic medications compared with 26% at discharge (Handwerk, Smith, Thompson, Spellman, & Daly, 2008). We also found that youth departing on medication were more likely to be male, younger, and rated as doing more poorly in the program.…”

Section: Dominant Lines Of Research Related To Residential Carementioning

confidence: 99%

Closing the Research to Practice Gap in Therapeutic Residential Care

Thompson

Hurley

Trout

et al. 2017

Journal of Emotional and Behavioral Disorders

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Residential care continues to be a significant sector in child and family services in the United States and across the world (Thoburn & Ainsworth, 2015). Current estimates for the United States indicate that there were more than 50,000 youth served in these settings in 2013 (U.S. Department of Health and Human Services, 2015). These youth tend to have more significant risk factors than youth treated in less restrictive placements. For example, a study by Pottick, Warner, and Yoder (2005) found that approximately 63% of youth in group care settings had dual clinical diagnoses compared with 50% of those in foster care; 30% in group care and 12% in foster care attempted or threatened suicide; 21% reported substance abuse compared with 10% in foster care; and 57% of youth in group care had impaired psychological and social functioning compared with 40% in foster care. In addition, the prevalence of serious emotional and behavioral problems among children in residential care settings appears to be on the increase (Duppong Hurley et al., 2009). Studies have also suggested that children served in residential settings have significant risks in other areas such as educational disabilities (Trout, Hagaman, Casey, Reid, & Epstein, 2008; Trout, Hagaman, Chmelka, et al., 2008) and physical health problems (Nelson et al., 2011). While many high-risk youth are served in residential care, during the past two decades there have been numerous concerns voiced regarding residential care such as the high cost of care, minimal development of residential theory and research evidence, general lack of integrating family and community supports, unclear youth placement criteria, minimal aftercare services, and possible iatrogenic effects (e.g., Annie E.

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“…It has also been reported that, on average, these youth experience clinical levels of both internalizing and externalizing behavior problems and between 55 and 60% engage in aggressive behavior (Breland-Noble et al 2005;CWLA 2005;Duppong Hurley et al 2009;Pottick et al 2005). As a result, it is not surprising that many of the youth who enter residential treatment have active prescriptions for psychiatric medications (Connor and McLaughlin 2005;Handwerk et al 2008).…”

Section: Introductionmentioning

confidence: 99%

Psychotropic Medication Use for Youth in Residential Treatment: A Comparison Between Youth with Monopharmacy Versus Polypharmacy

et al. 2010

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At the time of entry into residential treatment, many youth have prescriptions for one or more psychotropic medications. It is not well understood why some youth are prescribed only one psychotropic medication while others may be prescribed more. We sought to determine if differences existed between youth entering residential treatment with monopharmacy (n = 77) versus youth entering with polypharmacy (n = 103). Youth were compared across demographic, family, behavioral, mental health, and psychotropic medication variables. The only significant differences identified were related to the numbers of youth with prescriptions across the different psychotropic classes. As would be expected, youth experiencing polypharmacy were more likely to have prescriptions within each class. Implications, limitations, and recommendations for future research are discussed.

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Psychotropic Medication Utilization at a Group-Home Residential Facility for Children and Adolescents

Abstract: There was a high rate of psychotropic medication utilization among this population, though utilization rates dropped significantly over the course of treatment.

Cited by 22 publications

References 24 publications

Does Model Matter? Examining Change Across Time for Youth in Group Homes

Does Model Matter? Examining Change Across Time for Youth in Group Homes

Closing the Research to Practice Gap in Therapeutic Residential Care

Psychotropic Medication Use for Youth in Residential Treatment: A Comparison Between Youth with Monopharmacy Versus Polypharmacy

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